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目的:比较经尿道前列腺等离子剜除术(TPKEP)与耻骨上经膀胱前列腺切除术(OP)治疗大前列腺(>100g)的临床疗效。方法:选取2010年1月~2015年6月在我院住院接受手术治疗的、前列腺超过100g的120例良性前列腺增生(BPH)患者,随机纳入TPKEP组和OP组,每组各60例,分别统计对比两组患者的手术时间、术中出血量、手术切除前列腺腺体质量、术后保留导尿时间、膀胱冲洗时间、住院时间、术后6个月IPSS、Q_(max)、QOL、PVR的变化及术后6个月内并发症发生率。结果:两组患者均成功实施手术治疗。TPKEP组比OP组手术时间短、手术出血量少[(90.6±19.5)min vs.(120.0±18.7)min;(54.7±10.7)ml vs.(80.5±15.7)ml],差异有统计学意义(P<0.05);手术切除腺体质量[(TPKEP组(83.3±21.6)g vs.OP组(86.7±23.2)g],两组差异无统计学意义(P>0.05);TPKEP组比OP组术后保留导尿及住院时间短[(145.8±16.3)h vs.(192.3±12.1)h;(6.2±0.7)d vs.(8.6±2.5)d],两组差异有统计学意义(P<0.05);术后膀胱冲洗时间[TP〗,两组差异无统计学意义(P>0.05);术后随访6个月,两组患者的IPSS,Q_(max)、QOL、PVR均得到明显改善,两组差异无统计学意义(P>0.05);术后6个月内TPKEP组的总并发症发生率低于OP组(4.7%vs.6.5%),差异有统计学意义(P<0.05)。结论:TPKEP在治疗大前列腺上具有与耻骨上经膀胱前列腺切除术相似的近期疗效,相比之下,TPKEP具有手术时间更短,手术创伤及出血量更少,恢复更快,并发症发生率更低等优点,临床推广应用价值高,很可能成为传统开放手术治疗大前列腺增生的常规替代方法之一。
Objective: To compare the clinical efficacy of transurethral resection of the prostate (TPKEP) and suprapubic transvesical prostatectomy (OP) for the treatment of large prostate (> 100g). Methods: From January 2010 to June 2015, 120 patients with benign prostatic hyperplasia (BPH) who underwent surgery in our hospital who were surgically treated in our hospital were randomly divided into two groups: TPKEP group and OP group, with 60 cases in each group Statistical comparison of operation time, intraoperative blood loss, surgical removal of prostate gland mass, postoperative catheterization time, bladder irrigation time, hospital stay, IPSS, Qmax, QOL, PVR Changes and complications within 6 months after operation. Results: Both groups of patients were successful in surgical treatment. The TPKEP group had shorter operative time and less bleeding during operation than the OP group (90.6 ± 19.5 min vs 120.0 ± 18.7 min vs 54.7 ± 10.7 vs. 80.5 ± 15.7 ml, respectively) (P <0.05). There was no significant difference between the two groups (P> 0.05) in the group of TPKEP (83.3 ± 21.6 g vs. OP, 86.7 ± 23.2 g) The duration of catheterization and hospital stay was shorter in the group (145.8 ± 16.3 h vs. 192.3 ± 12.1 h and 6.2 ± 0.7 d vs. 8.6 ± 2.5 d, respectively) P <0.05). The postoperative bladder irrigation time (TP) had no significant difference between the two groups (P> 0.05). After 6 months of follow-up, IPSS, Q max, QOL and PVR (P> 0.05). The overall incidence of complications in TPKEP group was lower than that in OP group (4.7% vs.6.5%) within 6 months after operation (P> 0.05), and the difference was statistically significant (P <0.05) .Conclusion: TPKEP has similar short-term curative effect on suprapubic transvesical prostatectomy in the treatment of large prostate gland, in contrast, TPKEP has the advantages of shorter operation time, less trauma and bleeding, faster recovery, Lower complication rate and other advantages, clinical application of high value, it is likely to become a traditional open hand One alternative to conventional treatment of large prostate hyperplasia.